Topical Antifungal Prescribing for Medicare Part D Beneficiaries — United States, 2021

Kaitlin Benedict, MPH 1 ; Dallas J. Smith, PharmD 1 ; Tom Chiller, MD 1 ; Shari R. Lipner, MD, PhD 2 ; Jeremy A. W. Gold, MD 1 ( View author affiliations ) View suggested citation Summary What is already known about this topic? Severe antimicrobial-resistant superficial fungal infections have recently been detected in the United States; evaluating topical antifungal use is an initial step in developing strategies to prevent the global emergence and spread of these infections. What is added by this report? A total of 6.5 million topical antifungal prescriptions, costing $231 million, were filled for Medicare Part D beneficiaries in 2021, approximately one prescription for every eight beneficiaries. Most prescriptions were written by primary care physicians, nurse practitioners, or physician assistants. What are the implications for public health practice? The large volume of topical antifungal prescriptions in the context of emerging resistance highlights the need to better understand current prescribing practices and to encourage judicious prescribing by clinicians and improve patient education about recommended use. Article Metrics Altmetric: News (1) X (3) Citations: Views: Views equals page views plus PDF downloads Metric Details Tables Table 1 Table 2 Related Materials Article PDF Full Issue PDF Abstract Incorrect use of topical antifungals and antifungal-corticosteroid combinations is likely contributing to the global emergence and spread of severe antimicrobial-resistant superficial fungal infections, which have recently been detected in the United States. Understanding prescribing patterns is an initial step in establishing and promoting recommended use of these medications. Using 2021 Medicare Part D data, CDC examined prescription volumes, rates, and costs for topical antifungals (including topical combination antifungal-corticosteroid medications). Total prescription volumes were compared between higher-volume prescribers (top 10% of topical antifungal prescribers by volume) and lower-volume prescribers. During 2021, approximately 6.5 million topical antifungal prescriptions were filled (134 […]

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